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15 May 2013

I was loaned this book by a fellow therapist. I told her of a situation that I had been in, where a therapist had abused my trust, and that of other women, and I was struggling with the concept of how somebody can do that. She told me that my situation reminded her of this book.It is probably the seminal publication on the subject of abuse of power in therapeutic/mentoring relationships. The blurb on the back (on this 1990 edition) states:"In this moving and controversial book on sexual psychology, Peter Rutter explores the epidemic of sexual relations between men in authority and the women that they are meant to help."Reviews of the book state:"This is a landmark book. It explores the dynamics of power in male-female interactions and the tragic consequences when those with power betray their trust. It should be read by physicians, therapists, teachers, clergy and lawyers." Carol C Nadelson MDand"The depth and truth of Dr Rutter's insights into erotically charged relationships will challenge and empower both men and women to make choices that matter greatly. Sex in the Forbidden Zone should be read by everyone in the helping and mentoring professions" Jean Shinoda Bolen MDOur cultural attitudes towards abuse are changing. Just because it is horrifying and reflective of a part of humanity we'd rather didn't exist, doesn't mean that it doesn't exist. In fact, I believe that this aspect of ourselves, our sexual side, our more animalistic tendencies, are part of our collective shadow (in the Jungian sense - click here for some info). The taboo around frank sexual discussion could well have contributed towards our inability to deal with dysfunctional sexual relations when they arise. Instead, what society allows to leak out is pornography and the media portrayal of women as being "available" and in some parts of the world a huge anti-gay culture (with remnants here in the UK too, sadly). This doesn't seem healthy to me.By the way, I'm a feminist and a masculist.I digress (and for further digression along this tangent read this article on sexual assault and the chain of command: http://thefeministwire.com/2013/05/are-men-to-be-trusted-thoughts-on-sexual-assault-and-the-chain-of-command/Power in the therapeutic relationshipBack to the book. I do agree that it is essential reading for anybody working therapeutically in a position of power. I have a personal dislike of the use of the word power in the therapeutic relationship. I don't see myself as having power over my clients. I don't want to have power over my clients - I see us as being equal. But the fact is, when we open up to a therapist, we are trusting them, and anybody we trust has some power over us, because they can abuse their position. Our therapist has intimate knowledge about us, but we don't have the same knowledge of them. I don't like it, but it's there. It is something I cherish greatly, this privilege of being entrusted. As Yalom states, we are "cradlers of secrets".Rutter states that any sexual contact between a therapist and client is an abuse of position of trust because of the nature of the relationship, because the therapist often becomes a parental figure to the client. With this, the sexual exploitation is tantamount to incest, and the repercussions for the victim can be as devastating. It is interesting to note, that when I told the therapist (the one who abused my trust) that he was kind of like a father figure for me, he looked horrified and said "I do hope not". Another male therapist with whom I saw in a fatherly way was touched when I told him. Such a stark contrast."Because the forbidden zone reawakens these childlike parts within us, acquiescence to sex under these emotional circumstances can hardly be equated with adult consent. In the light of these underlying dynamics there can be no such thing as consent in the adult sense, to a sexual act by a woman with a man who has power over her in the forbidden zone. A man of this position of trust and authority becomes unavoidably a parent figure and is charged with ethical responsibilities of the parenting role. Violations of these boundaries are, psychologically speaking... acts of incest."So, like any profession out there, there are a few rotten apples. There are some who are called to the caring professions because their shadow side takes them there. The statistics are worrying. The book refers to research on sexual exploitation by psychotherapists. The study looked at therapists who had treated patients who had a sexual relationship with a previous therapist. 70% of therapists reported at least one patient who had had such a relationship, 96% of these previous therapists were male. The book also looks at sexual exploitation between clergymen-parishioner and teacher/student relationships but my focus is on psychotherapy as this is the field in which I am familiar (although I have awareness of a clergyman abusing his position of trust with at least two parishioners, sadly, and of course the papers abound with stories about the church and abuse).Like I have mentioned before, I cannot believe that counselling and psychotherapy are unregulated professions in the UK. It won't stop abusive therapists but will help make them accountable and give a course of action for people to take if they are affected by somebody's inappropriate behaviour (sexual or otherwise - breach of confidentiality, amongst other things, is also an abuse of trust).I earmarked a few pages of this book as they really spoke to me and reached the part of me that was in an abusive situation with somebody I trusted, and the part of me that is in touch with and has heard the many stories of other people (male and female) who have been abused in one way or another. When I read articles on the internet with comments from the public such as "how could she be so stupid" or comments regarding Savile's victims saying "she must be lying - how can she have gone on all this time without saying anything" I feel immense frustration. I have been on the receiving end of such tripe. This is utter nonsense. Anybody who has an ounce of empathy will know that being on the receiving end of an abuse of trust has an extremely complex response to the abuse. It can take victims years to speak up, if ever. To speak up is unfathomably hard. And usually it is only one person's word against a manipulative, powerful individual. Such attitudes perpetuate abuse.Rutter has a chapter illustrating the snapshot of a man who crosses the boundary. There are warning signs. Clinical supervision is an ethical necessity for therapists and erotic feelings towards clients should be explored professionally. Bury them and they'll pop out again somewhere and you'll have little control over them, is the message.This paragraph stood out as particularly interesting:"Success itself puts a man at higher risk for feeling that he can make his own rules and that his word (or his fabrications) will be believed against the words of a woman who challenges him. In most of the case histories I gathered for this book, the man who had a sexual relationship in the forbidden zone had been considered an outstanding member of his profession."Power rears it's head again. The higher the position of power the more likely the propensity to abuse trust. Remember that quote? "Power corrupts, absolute power corrupts absolutely".Give me humility over power any day.[This book has also been reviewed in January 2015 by Phil Dore in his Not So Big Society blog]